Skip to main content
Log in

Echocardiographic evaluation of right heart function and pulmonary vascular bed

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

The aim of this review was to describe the different ultrasonic modalities to non-invasively evaluate right cardiac chambers and pulmonary vascular bed function. M-Mode, 2-D, conventional pulsed doppler, tissue doppler imaging (TDI), strain rate imaging (SRI) and 3D echocardiography are illustrated in order to obtain both regional and global right heart and pulmonary function. The results have a good correlation with other invasive and non-invasive diagnostic techniques, as magnetic resonance imaging (MRI). All these echocardiograpic techniques can be employed to evaluate the morphologic and functional pictures of right heart and pulmonary circulation in presence of pulmonary hypertension (PH). The hemodynamic profile obtained consent to anatomically and functionally characterize PH. But, other experiences performed on more wide range of healthy and PH patients are necessary to confirm the described results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Konstam MA, Pandian N (1988) Assessment of right ventricular function. In: Konstam MA, Isner JM (eds) The right ventricle. Kluwer, Boston, pp 1–15

    Google Scholar 

  2. Furey SA, Zieske HA, Levy MN (1984) The essential function of the right ventricle. Am Heart J 107:404–410

    Article  PubMed  Google Scholar 

  3. Cosio FG, Anderson RH, Kuck KH et al (1999) Living anatomy of atrioventricular juntions. A guide to electrophysiologhic mapping. A consensus statement from the cardiac nomenclature study group, working group of arrhythmias. European society of cardiology, and the task force on cardiac nomenclature from NASPE. Circulation 100:E31–E37

    PubMed  CAS  Google Scholar 

  4. Weideman F, Eyskens B, Jamal F et al (2002) Quantification of regional left and right ventricular radial and longitudinal function in heathy children using ultrasound-based strain and strain rate imaging. J Am Soc Echocardiogr 15:20–28

    Article  Google Scholar 

  5. Linqvist P, Calcutteea A, Henein M (2008) Echocardiography in the assessment of right heart function. Eur J Echocardiogr 9(2):225–234

    Google Scholar 

  6. Feigenbaum H (1994) Echocardiography. Lea & Febiger, Philadelphia

    Google Scholar 

  7. Jiang L, Wiegers S, Weyman AE (1994) Right ventricle. In: Weyman AE (ed) Principles and pratice of echocardiography. Lea & Febiger, Philadelphia, pp 901–921

    Google Scholar 

  8. Kaul S, Tei C, Hopkins JM, Shah PM (1984) Assessment of right ventricular function using two-dimensional echocardiography. Am Heart J 107:526–531

    Article  PubMed  CAS  Google Scholar 

  9. Ueti OM, Camargo EE, de Ueti A, de Lima-Filho EC, Nogueira EA (2002) Assessment of right ventricular function with doppler echocardiographic indices derived from tricuspid annular motion: comparison with radionuclide angiography. Heart 88:244–248

    Article  PubMed  CAS  Google Scholar 

  10. Kircher BJ, Himelman RB, Schiller NB (1990) Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol 66:493–496

    Article  PubMed  CAS  Google Scholar 

  11. Willens HJ, Fertel DP, Qin J, Labrador E, Lowery MH (2008) Effects of age and pulmonary arterial hypertension on the different phases of right atrial function. Int J Cardiovasc Imaging. doi: 10.1007/s10554-008-9306-4

  12. Ueda R, Yokouchi M, Andou H, Suzuki T, Yamaoka M, Otomo E, Takahashi A, Katagiri T (2004) Pulmonary artery systolic pressure is elevated in the elderly: relationships between echocardiographic and pathological findings. Int Med 43:374–378

    Article  Google Scholar 

  13. Verbeken EK, Cauberrhs M, Mertens I, Clement J, Lauweryns JM, Van de Woesrijne KP (1992) The senile lung. Comparison with normal and emphysematous lungs. I. Structural aspects. Chest 101:793–799

    Article  PubMed  CAS  Google Scholar 

  14. Verbeken EK, Cauberhs M, Mertens I, Clement J, Lauweryns JM, Van de Woestijne KP (1992) The senile lung. Comparison with normal and emphysematous lungs. 2 Functional aspects. Chest 101:800–809

    Article  PubMed  CAS  Google Scholar 

  15. McQuillan BM, Picard MH, Leavitt M, Weyman A (2001) Clinical correlates and reference intervals or pulmonary artery systolic pressure among echocardiographically normal subjects. Circulation 104:2797–2802

    Article  PubMed  CAS  Google Scholar 

  16. Friedberg MK, Feinstein JA, Rosenthal DN (2006) A novel echocardiographic doppler method for estimation of pulmonary arterial pressures. J Am Soc Echocardiogr 19(5):559–562

    Article  PubMed  Google Scholar 

  17. Castelain V, Chela D, Humbert M et al (2002) Pulmonary artery pressure-flow relations after prostacyclin in primary pulmonary hypertension. Am J Respir Crit Care Med 165:338–340

    PubMed  Google Scholar 

  18. Himelman R, Stulbarg M, Kircher B, Lee E, Kee L, Dean NC, Golden J, Wolfe CL, Schiller N (1989) Noninvasive evaluation of pulmonary artery during exercise by saline-enhanced doppler echocardiography in chronic pulmonary disease. Circulation 79:863–871

    PubMed  CAS  Google Scholar 

  19. Alkotob ML, Soltani P, Sheatt MA, Katestos MC, Rothfield N, Hager WD, Foley RJ, Silverman DI (2006) Reduced exercise capacity and stress-induced pulmonary hypertension in patients with scleroderma. Chest 130:176–184

    Article  PubMed  Google Scholar 

  20. Brown KA, Okada RD, Boucher CA, Strauss HW, Pohost GM (1984) Right ventricular ejection fraction response to exercise in patients with coronary artery disease: influence of both right coronary artery disease and exercise-induced changes in right ventricular afterload. J Am Coll Cardiol 3:895–901

    Article  PubMed  CAS  Google Scholar 

  21. Chaudhry FA, Tauje JT, Alessandrini RS, Vardi G, Parker MA, Bonow RO (1999) Prognostic implications of myocadial contractile reserve in patients with coronary artery disease and left ventricular dysfunction. J Am Coll Cardiol 34:730–738

    Article  PubMed  CAS  Google Scholar 

  22. Weyman AE, Wann LS, Feigenbaum H et al (1976) Mechanism of abnormal septal motion in patients with right volume overload. Circulation 54:179–186

    PubMed  CAS  Google Scholar 

  23. Feneley M, Garagham T (1986) Paradoxical and pseudoparadoxical interventricular septal motion in patients with right ventricular volume overload. Circulation 74:230–238

    PubMed  CAS  Google Scholar 

  24. Saito A, Ueda K, Nakano H (1981) Right ventricular volume determinations by two-dimensional echocardiography. J Cardiogr 11:1159–1168

    PubMed  CAS  Google Scholar 

  25. Wann LS, Stikels KR, Bamrah VS et al (1984) Distal processing of contrast echocardiograms: a new technique for measuring right ventricular ejection fraction. Am J Cardiol 53:1164–1168

    Article  PubMed  CAS  Google Scholar 

  26. Levine RA, Gibson TC, Aretz T et al (1984) Echocardiographic measurement of right ventricular volume. Circulation 69:497–505

    PubMed  CAS  Google Scholar 

  27. Gibson TC, Miller SW, Aretz T et al (1985) Method for estimating right ventricular volume by planes applicable to cross-sectional echocardiography: correlation with a geographic formulas. Am J Cardiol 55:1584–1588

    Article  PubMed  CAS  Google Scholar 

  28. Jiang L, Levine RA, Weyman AE (1997) Echocardiographic assessment of right ventricular volume and function. Echocardiogrphy 14:189–205

    Article  Google Scholar 

  29. Tei C, Ling LH, Hodge DO et al (1995) New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function. A study in normal and dilated cardiomyopathy. J Cardiol 26:357–366

    PubMed  CAS  Google Scholar 

  30. Kamati PK, Mohammed E, Torosoff M, Fein S (2008) Myocardial performance index correlates with ventricular ejection fraction measured by nuclear ventriculography. Echocardiography 25:381–385

    Article  Google Scholar 

  31. Acharya G, Pavlovic M, Ewing L, Nollmann D, Leshko J, Huhta JC (2008) Comparison between pulsed-wave Doppler- and tissue Doppler-derived Tei indices in fetuses with and without congenital heart disease. Ultrasound Obstet Gynecol 31(4):406–411

    Article  PubMed  CAS  Google Scholar 

  32. El-Damarawy M, Zeidan H, Suwailem S (2008) Myocardial performance index in patients with chronic obstructive pulmonary disease. Heart Mirror J 2(2):60–66

    Google Scholar 

  33. Garcia MJ, Rodriguez L, Ares M, Griffin BP, Klein AL, Stewart WJ (1996) Myocardial wall velocity assessment by pulsed doppler tissue imaging: characteristic findings in normal subjects. Am Heart J 132:648–656

    Article  PubMed  CAS  Google Scholar 

  34. Isaaz K, Munoz del Romeral L, Lee E, Schiller NB (1993) Quantitation of the motion of the cardiac base in normal subjects by doppler echocardiography. J Am Soc Echocardiogr 6:166–176

    PubMed  CAS  Google Scholar 

  35. Linqvist P, Waldenstrom A, Wikstrom G, Kazzam E (2005) The use of isovolumic contraction velocity to determine right ventricular state of contractility and filling pressures. A pulsed doppler tissue imaging study. Eur J Echocardiogr 6:264–270

    Article  Google Scholar 

  36. Meluzin J, Spinarova L, Bakala J, Toman J, Krejci J, Hude P (2001) Pulsed doppler tissue imaging of the velocity of tricuspid annular systolic motion; a new, rapid, and noninvasive method for evaluating right ventricular systolic function. Eur Heart J 22:340–348

    Article  PubMed  CAS  Google Scholar 

  37. Jamal F, Bergerot C, Argaud L, Loufouat J, Ovize M (2003) Longitudinal strain quantitates regional right ventricular contractile function. Am J Physiol Heart Circ Physiol 285:H2842–H2847

    PubMed  CAS  Google Scholar 

  38. Eysken B, Weidemann F, Kowalski M et al (2004) Regional right and left function after the senning operation: an ultrasonic study of strain rate and strain. Cardiol Young 14:255–264

    Article  Google Scholar 

  39. Bleeker GB, Steendijk P, Holman ER, Yu CM, Breithardt OA, Kaandorp TAM, Schalij MJ, van der Wall EE, Nihoyannopoulos P, Bax JJ (2006) Assessing right ventricular function: the role of echocardiography and complementary technologies. Heart 92:i19–i26

    Article  PubMed  Google Scholar 

  40. Vitarelli A, Conde Y, Cimino E, Stellato S, D’Orazio S, D’Angeli I, Nguyen BL, Padella V, Caranci F, Petroianni A, D’Antoni L, Terzano C (2006) Assessment of right ventricular function by strain rate imaging in chronic obstructive pulmonary disease. Eur Respir J 27:268–275

    Article  PubMed  CAS  Google Scholar 

  41. Toyoda T, Baba H, Akasaka T, Akiyama M, Neishi T, Tomita J, Sukmawan R, Koyama Y, Watanabe N, Tamano S, Shinomura R, Komuro I, Yoshida K (2004) Assessment of regional myocardial strain by novel automated tracking system from digital image files. J Am Soc Echocardiogr 17:1234–1238

    Article  PubMed  Google Scholar 

  42. Matsui H, Satomi G, Yasukochi S, Kaneko S, Haseyama K (2008) Evaluation of right ventricular contraction by myocardial strain in children using two-dimensional tissue tracking method. Pediatr Cardiol 29:377–381

    Article  PubMed  CAS  Google Scholar 

  43. Tong C, Li C, Song J, Liu H, Deng Y (2008) Assessment of right ventricular free wall longitudinal myocardial deformation using speckle tracking imaging in normal subjects. J Huazhong Univ Sci Technol (Med Sci) 28(2):194–196

    Google Scholar 

  44. Pirat B, Culloch ML, Zoghbi W (2006) Evaluation of global and regional right ventricular systolic function in patients with pulmonary hypertension using a novel speckle tracking method. Am J Cardiol 98:699–704

    Article  PubMed  Google Scholar 

  45. Jenkins C, Chan J, Bricknell K, Strudwick M, Marwick TH (2007) Reproducibility of right ventricular volumes and ejection fraction using real-time three-dimensional echocardiography. Chest 131:1844–1851

    Article  PubMed  Google Scholar 

  46. Angeline ED, Homma S, Pearson G, Holmes JW, Laine AF (2005) Segmentation of real-time three-dimensional ultrasound for quantification of ventricular function: a clinical study on right and left ventricles. Ultrasound Med Biol 31:1143–1158

    Article  Google Scholar 

  47. Joachim NH, Wolfgang T, Ayan P, Navroz MD, Bernhard M, Pandian N (2006) Quantitation of right ventricular volumes and ejection fraction by three-dimensional echocardiography in patients: comparison with magnetic resonance imaging and radionuclide ventriculography. Echocardiography 8:666–680

    Google Scholar 

  48. Papavassiliou DP, Parks WJ, Hopkins KL, Fyfe DA (1998) Three-dimensional echocardiographic measurement of right ventricular volume in children with congenital heart disease validated magnetic resonance imaging. J Am Soc Echocardiogr 11(8):770–777

    Article  PubMed  CAS  Google Scholar 

  49. Fujimoto S, Mizuno R, Nagakawa Y, Dohi K, Nakano H (1998) Estimation of the right ventricular volume and ejection fraction by trans-thoracic three-dimensional echocardiography.A validation study using magnetic resonance imaging. Int J Card Imaging 14(6):385–390

    Article  PubMed  CAS  Google Scholar 

  50. Tamborini G, Brusoni D, Torres Molina JE, Galli CA, Maltagliati A, Muratori M, Susini F, Colombo C, Maffessanti F, Pepi M (2008) Feasibility of a new generation three-dimensional echocardiography for right ventricular volumetric and functional measurements. Am J Cardiol 102:499–505

    Article  PubMed  Google Scholar 

  51. Schulman DS, Matthay RA (1992) The right ventricle in pulmonary disease. In: Smiley I, Rich S, Mc Laughlin VV (eds) Cardiology clinics: the right ventricle. WB Saunders, Philadelphia, pp 111–135

    Google Scholar 

  52. Dhainaut JFA, Doise JM, Brunet F (1996) Heart-lung interaction in chronic ostructive pulmonary disease. In: Derenne JP, Whitelaw WA, Smilowski T (eds) Acute respiratory failure in chronic obstructive pulmonary disease. New York, Marcel Dekker, pp 267–302

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Federico Cacciapuoti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cacciapuoti, F. Echocardiographic evaluation of right heart function and pulmonary vascular bed. Int J Cardiovasc Imaging 25, 689–697 (2009). https://doi.org/10.1007/s10554-009-9478-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-009-9478-6

Keywords

Navigation